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Invincible: An Ironman’s quest to regain his lifestyle after robotic heart surgery

Fall 2012

Grit. Resolve. Determination. These words characterize the seemingly invincible men and women who take on the grueling challenge of Ironman Triathlons and all are words that capture the essence of 53-year-old Ironman Brian Keast.

Consisting of a 2.4-mile swim, a 112-mile bike and a full marathon run of 26.2 miles, Ironman Triathlons are not for the faint of heart. These races test the physical and mental limits of even the most elite athletes; and after spending nearly 30 years competing in them, Keast has experienced his share of peaks and valleys.

In the spring of 2007, Keast was still reeling from the high of winning his age group at the 2006 Ironman World Championships in Hawaii, but the feeling began quickly fading as he started experience difficulties while training.

“I started to get a persistent cough while exercising that was accompanied by unusual pain and I knew that something wasn’t quite right,” recalls Keast.

After a visit to his family doctor and an arsenal of tests, the source of the nagging cough and pain was uncovered – Keast had a complete blockage of the left anterior descending artery and traditional bypass surgery was promptly scheduled. For Keast, receiving this news would be the beginning of a journey through one of the most challenging valleys in his life.

“My entire lifestyle revolves around being active. I had been training extensively with reasonable success, so to be told that I needed to have bypass surgery wasn’t just surprising – it was shocking,” says Keast. “My analytical side kicked in pretty fast and even though things were moving forward quickly, I wanted to find out more about what the best treatment was, how long the recovery period would be and what the possible long-term effects were.”

The gift of the time he needed to find those answers would come in a truly unexpected form.

Shortly after his diagnosis, he was rushed to his local emergency department barely able to breathe and sure he was suffering a heart attack. Relieved to learn it was pneumonia and not a heart attack, yet disappointed to learn that his surgery would be delayed, Keast chalked it up to just another challenge he would have to overcome. That was, until he met up with an old swimming buddy who encouraged him to see the delay as an opportunity to explore the various options available and not just simply accept the traditional surgical approach.

The friendly boost would push him to learn about alternatives and find that CSTAR (Canadian Surgical Technologies and Advanced Robotics) and cardiac surgeon Dr. Bob Kiaii were less than an hour’s drive away at London Health Sciences Centre. This discovery would go on to serve as the first route marker in Keast’s uphill climb out of that valley.

After quickly arranging an appointment and meeting with Dr. Kiaii, he had learned the many benefits that minimally invasive surgery would offer him, versus undergoing the traditional bypass surgery. Chief among the benefits was the reduced recovery time as the robotically assisted surgery would eliminate the need to open up his chest cavity.

“I wouldn’t be me if I couldn’t be active and I wasn’t ready or willing to pack it in and find a new set of hobbies,” says Keast. “I was determined to get back to my lifestyle as quickly as possible and this surgery was going to allow me to do just that.”

LHSC cardiac surgeon Dr. Kiaii, his physician team of Dr. Swinamer and Dr. Rayman and anaesthetist Dr. Dobkowski, would successfully perform the surgery in September and Keast would go on to begin training again within the week.

It was a slow and steady climb that would lead him out of the valley, supported each step along the way by the team at LHSC.

“Very rarely do we have patients that are as athletic as Brian,” says Dr. Kiaii. “He went into surgery determined and with an agenda in mind for how quickly he would recover. The most important thing for Brian was to be able to achieve his previous level of athleticism and we wanted to help him succeed. At the end of the day, that’s what we want for all of our patients.”

And succeed, he did. One year after his surgery, Keast once again crossed the finish line of the Ironman World Championships in Hawaii. He did so with 100 per cent confidence in his heart and a focused mind free of medical distractions – a true picture of grit, resolve and determination. He was once again standing at a peak. He was once again an invincible Ironman.

Community Support

Brian Keast’s minimally invasive, robotically assisted heart surgery and subsequent return to Ironman Triathlon competitions couldn’t have happened without the generosity and foresight of donors to London Health Sciences Foundation, which led to a grant from the Canadian Foundation for Innovation. From the first two generations of surgical robots at LHSC – the single-arm AESOP and the three-armed ZEUS – to the da Vinci robot used in Brian’s surgery, donors have played a critical role in establishing LHSC as a national leader in minimally invasive robotic surgery. Learn more about the next generation of donor-supported robotic surgery at www.lhsf.ca/robotic.

Why do blocked arteries happen?

Learn about blocked arteries and how to spot the early warning signs from Dr. Bob Kiaii, cardiac surgeon at LHSC.

Want to see surgical footage?

Dr. Kiaii and his physician team perform minimally invasive cardiac surgery at LHSC.

What is CSTAR?

CSTAR (Canadian Surgical Technologies and Advanced Robotics), and the Kelman Centre for Advanced Learning within, is the finest simulation skills training facility in the country. The 22,500 square-foot facility is one of the four Canadian Accredited Education Institutes of the American College of Surgeons.

CSTAR’s vision is to be an international leader in health care technology innovation. Its mission is to improve the quality and safety of care for patients through computer-assisted health care technology innovation from research and development of novel technologies to the delivery of simulation training.

Through London Health Sciences Centre, CSTAR doctors have produced a number of world and Canadian firsts in computer assisted minimally invasive surgery and have been national leaders in the introduction of robotic surgery into the Canadian health care system.

CSTAR researchers currently hold over $20 million in peer review research funding focused on minimally invasive, image-guided and robotic-assisted technologies for therapies and simulation training.